Individual
JASON DUREL VANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8122 LEE HALL AVE, SUFFOLK, VA 23435-3444
(757) 452-8009
Mailing address
8122 LEE HALL AVE, SUFFOLK, VA 23435-3444
(757) 452-8009
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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